Non-Hodgkin's lymphoma is a tenacious systemic cancer. In its advanced stages, it doesn't respond to chemotherapy or even to a combination of chemo and radiotherapy. If that's the case, why treat at all when the aggressive treatment will affect the quality of life of the patient without producing any positive gains?
The British National Lymphoma Investigation has tackled this thorny ethical issue, and concluded that it is as well to do nothing, especially if the patient is over 70 years of age. They studied 309 patients with advanced stage non-Hodgkin's lymphomas; 158 were given immediate chemotherapy, and the rest were not treated until the disease progressed. Survival rates in the two groups was similar, and 19 of the patients who never received any treatment were still alive 10 years later.
'Watchful waiting' was as valid a treatment course as chemotherapy, the research team concluded.
(Source: The Lancet, 2003; 362: 516-22).